INTERNATIONAL HEALTH AND MEDICAL RESEARCH ACT OF 1959 WEDNESDAY, FEBRUARY 25, 1950 UNITED STATES NENATE, COMMITTEE ON LABOR AND PUBLIC WELPARM, The committee met, pursuant to adjournment, at 10:05 am, in room 4232, New Senate Office Building, Hon. Lister Hill (chairman) presiding. Present: Senators Hill (presiding), Yarborough, Williams, and Case. Committee staff members present: Stewart E. McClure, chief clearly William G. Reidy and Raymond Hurley, professional staff members The CHARMAN. The committee will kindly come to order We wil sine our hearings this morning on Menate Joint House lution 4 the national medical research bill. Ou frs. vimese this morning is Dr. L. S. Haydin. Dr. Levin, vaid you come around, please, sir? Dr. Lavin & Te president in charge of medical affaire wt the Unverary of Penney Jania, and one of the moak, keustach, wenn genre, in the Chhet write Your remitation. Doetur, qua to many landa and wvary brandkiem, We are her tangy and pris.leged to fare que, saam kile wanway. We mil a gut low to hate y'a proost in pour q*i **7, ** SLACEMENT IP JR. I 1 RATDIN, VICZ PYXIZIDUNT OR MEDICAL DMPITT, ISHTERSITY OF YLSKEYLVANIA I mar Elll and remier A na smune, 1 dick 'N woaring a vora des gan sat in I spent a good part of 1927 in Scotland and England working in basic medical science. During World War II I served in the China, Burma, India theater of operations. The organization which I commanded took care of American, Chinese and British troops. We had the opportunity of seeing and treating diseases that were new to us, such as scrub typhus and filariasis; of seeing and treating diseases which had in very large part been conquered by American scientists, such as malaria in all of its forms, including cerebral malaria; and of seeing many aspects of malnutrition and its related problems. I was struck by the fact that the two Chinese armies serving under Gen. Joseph Stilwell were provided with totally inadequate medical support; that no provision had been made for the procurement of blood for use in seriously ill or severely injured Chinese casualties; that such medical support as they had included less than minimal laboratory and public health personnel. I would remind you, sir, that when the 19th century opened, pain, hemorrhage and infection still seriously hampered the surgeon's work. In 1799 Humphrey Davy, working in Dr. Badeaux's laboratory in southern England with various gases, reported on the use of nitrous oxide, and he stated: Since nitrous oxide is capable of annulling pain, it might be used in surgical operations in which there is no great effusion of blood. In 1842 Crawford Long, a graduate of the School of Medicine of the University of Pennsylvania, first used ether anesthesia for an operation on James Venable in Athens, Jackson County, Ga.; that hemorrhage, during and after operation, began to come under control with the development of the absorbable suture by Philip Syng Physick; and that James Joseph Lister in 1866 introduced the carbolic acid spray as a method of destroying airborne bacteria which previously had resulted in the nearly universal infection of wounds, with the result of so-called laudable pus. Here, indeed, was international cooperation, for these events laid the foundation for modern surgical effort. The further discovery and elaboration of a variety of anesthetic agents freed the surgeon from the pressure of speed in an operation. Surgeons, with their patients carefully anesthetized, realized that they could proceed more carefully with an operation, minimizing hemorrhage, handling tissues more gently, and carefully considering each step of the operation. I have referred briefly to the importance of the use of blood in the seriously sick and injured. This use has been tremendously expanded in areas where a high level of medicine and surgery exists. As this has taken place, we have found more and more areas where intensive research is required in order to make the simple procedure of the transfer of blood safer. Many investigators here and overseas have participated in the solution of certain of these previously unsolved mysteries. A great deal, however, remains to be done. There are many areas of the world where the level of medicine and surgery is not high. We can play an important part in improving it. There are many diseases which cause a high toll in suffering and of life here and overseas, such as cancer, blindness, mental diseases, cardiovascular diseases and a host of others. There are in ny of the countries where these disorders exist men trained in research methods who can assist in the solving of these health problems which each year take a heavy toll of life or produce continuing disability. I venture to state that a national institute for international medical research which would "mobilize the efforts of medical scientists, research workers, technologists, and members of the health professions for an assault upon disease, disability, and the impairments of man" would create the circumstances for a better international understanding than can be achieved by any other means. It is my personal opinion that such an institute should be set up within the present framework of the National Institutes of Health; and that it functions as do the existing Institutes in regard to funding, the awarding of research grants, training and research fellowships. and contracts. This could be done while at the same time providing for supervision and direction by the Secretary of Health, Education, and Welfare and the safeguards necessary for the program to be in harmony with the foreign policy of this country. The aspects of the overall problem which concern the Office of Vocational Rehabilitation and the Children's Bureau could be protected by representation on the Advisory Council as is now done for the Army, Navy, Air Force, and Veterans Administration. I know that the impact of a program such as you have conceived will be of enormous value to mankind. People throughout the world will come to know what the hallmarks of an adequate health program really are. Those of us who have lived through this period of major advances in the medical sciences know that this will be a slow process. New developments in health fields will be made by those who have had long training in highly specialized fields of medical science. We must, through means such as this bill envisages, strengthen the philosophy of free discussion and inquiry. The layman is apt to think of a scientist as one who possesses, in addition to wide technical knowledge, some magic gift for discovering truth. Every scientist will hasten to reply that he has no such magic gift, that indeed there is no magic touchstone of any kind for the discovery of truth. Science discovers truth the hard way; entertaining no a priori certitudes, she starts from absolute ignorance and, by tested and critical procedures, little by little wrests from nature successive fragments of information which prove to be verifiable by competent observers at all times and in all places. In his state of the Union message, the President stressed the importance of intensified effort in the health field. I would hope that such an effort is supported by everyone interested in a better world for the future. The President did, in fact, state: By these and other means we shall continue and expand our campaign against afflictions that now bring suffering and death to so many of the world's peoples. We wish to be part of a great shared effort toward the triumph of health. If we ever reach this objective, we must strengthen basic research not only in this country but in many other countries. We must strengthen research and research training in those areas which will contribute to a better understanding of the abnormalities from normal function imposed by wide varieties of disorders. We must concern ourselves with the rehabilitation of those who, through more adequate therapy, can play a useful role in society. We must extend our responsibilities and concern ourselves not only with the problems which are of importance to our own people, but those which prevent many other people from participating freely in the benefits which we have come to know can be expected from carefully planned and skillfully executed research. Where competent research is being done under wise leadership, we should strengthen it, if this can be done and needs to be done. If re search manpower is inadequate, we should provide the funds to improve it. While this will in certain instances require the training of men and women in this country, I am sure that you realize that in numerous countries where freedom is treasured as much as it is in our own country, splendid research is now being done. In them, when funds are needed to prime the pump, we should provide them. If American research workers and rehabilitation experts are needed to demonstrate what can be accomplished when an adequate overall program is instituted, we should be prepared to send them where they are needed. I need not, I am sure point out to you and your associates that there are numerous international organizations attempting to participate in small segments of what your bill envisages. We should encourage those that are now operating in various geographic areas and in a variety of fields of effort. The goal will be achieved more rapidly by a full scale effort than by a restricted approach to this problem. This Nation has long realized that a lack of concern for the problems of the health of people leads all too frequently to poverty, to diseases which sap the physical and mental vigor of people, and finally to revolt. We who have gained so much from the research of our own scientists and those from other countries, where good research has been and is being done, must realize that the more quickly we can assist those less fortunate to begin to achieve what we have so fortunately achieved, the more quickly universal understanding will be won in our troubled world. The CHAIRMAN. Thank you, Doctor. Doctor, you spoke of the President. You were a participant, I believe, in a noted operation for ileitis not too long ago. Is that not true? Dr. RAVDIN. Yes, sir, I was one of those participating. The CHAIRMAN. Doctor, I was impressed by the emphasis that you gave to the need for basic research. You would carry on research not only in the special fields such as heart, cancer, neurology, but also in basic biological research, would you not? Dr. RAVDIN. Yes, sir; I think that is very important. The CHAIRMAN. Doctor, you had intimate insight into the work of our Institutes. Are you not a member of the American Cancer Council? Dr. RAVDIN. I am a director of the American Cancer Society. The CHAIRMAN. You have also served on the council, have you not? Dr. RAVDIN. Not now, but I was for 4 years on the National Advisory Council. The CHAIRMAN. On the Advisory Council for the Cancer Institute? Dr. RAVDIN. And I am now chairman of the clinical panel of the Cancer Chemotherapy National Service Center. The CHAIRMAN. And, of course, in those positions, as well as in your daily practice, you see the great need and, may I say, the great opportunity and challenge for this international program of research? Dr. RAVDIN. I do, sir. I think it is very important. The CHAIRMAN. Not only to stimulate and carry on the research that we are doing in this country, but to try to pool together research in many other lands today? Dr. RAVDIN. Senator, at least in medicine, you are dealing with something that is universal, and in which understanding is nearly universal in this world. The CHAIRMAN. If all people are God's children, then all people are concerned with medical research; is that not true? Dr. RAVDIN. That is right, sir. Senator YARBOROUGH. I would say, Dr. Ravdin, that I consider this a most interesting statement you have made to the committee this morning, one that will be highly useful to us in our deliberations on this resolution; and as a coauthor, I want to express my personal appreciation. The CHAIRMAN. Doctor, you brought us a very fine, informative, and stimulating message, a challenging message, and we deeply appreciate it. We thank you very, very much. Dr. RAVDIN. Thank you, sir. The CHAIRMAN. Our next witness is Mr. John T. Connor, president of Merck & Co. Mr. Connor, we are privileged to have as a member of our committee one of your fellow townsmen, Senator Case. I am going to ask Senator Case if he would like to say a word at this time. Senator CASE. I would like very much to say a word, Mr. Chairman, and you are most thoughtful. As a matter of fact, my colleague, Senator Williams, perhaps would like to have one, too, because Senator Williams and I come from about 4 miles apart in the same county, and in the same county is Merck & Co. and the present witness, who is, though a young man, the head of that extraordinarily fine organiaztion. It is a privilege for us to have here a New Jersey representative of a great industry, a representative from my home town, a personal friend, a man of great distinction. I suppose one of the reasons that I like Jack Connor is that he also got his start as a lawyer. I always think that the law is probably the best start for any kind of thing, and anybody who demonstrates that this is right appeals to me. He provides the best demonstration I know of that a good lawyer is the best kind of a fellow for any kind of a job. We are proud to have him in New Jersey. We are proud to have him in my home town. And I am very proud, as I know Senator Williams is, to have him here before our committee. The CHAIRMAN. Senator Williams, we would be happy to have you say a word. Senator WILLIAMS. I join my colleague and friend, Senator Case, in all of his remarks. Of course, this is a very wise lawyer, who went into broader fields. I just want to say that in my judgment Merck & Co. has done a magnificent job in its work around the world in dispelling misconceptions about this country and establishing the fact, as we know it is a fact, that Americans are concerned with the welfare of all people. And we want to assist within our means the legitimate aspirations of people throughout the world for a better life. I know of examples of this in the history of Merck & Co., and maybe we could touch on one or two later. Thank you for being here. |